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Vedolizumab Is Better for Ulcerative Colitis Than Crohn's Disease

In December 2013, two Food and Drug Administration (FDA) advisory committees voted in favor of recommending vedolizumab for treatment of both types of inflammatory bowel disease. A theoretical concern about vedolizumab is the risk of progressive multifocal leukoencephalopathy (PML), a potentially fatal brain infection associated with vedolizumab's parent molecule, natalizumab (Tysabri), which is approved for use in both multiple sclerosis and CD. Edward V. Loftus Jr., M.D., a gastroenterologist at Mayo Clinic in Minnesota, points out that natalizumab affects adhesion molecules at the level of the blood-brain barrier system as well as in the gut. "The goal has always been to develop more gut-specific targets," he says.